Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 20A6634 | CA |
NPI | 1346235157 |
---|---|
Provider Name | Dr. Rebecca L Perlow |
First Address | Tarzana, CA 91356-6117 |
Second Address | Tarzana, CA 91356-3647 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G47750 | (02) | CA |